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World J Diabetes. Aug 15, 2021; 12(8): 1255-1266
Published online Aug 15, 2021. doi: 10.4239/wjd.v12.i8.1255
Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery
Ursula Galway, Praveen Chahar, Marc T Schmidt, Jorge A Araujo-Duran, Jeevan Shivakumar, Alparslan Turan, Kurt Ruetzler
Ursula Galway, Praveen Chahar, Alparslan Turan, Kurt Ruetzler, Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Praveen Chahar, Department of Intensive Care and Resuscitation, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Marc T Schmidt, Jorge A Araujo-Duran, Jeevan Shivakumar, Alparslan Turan, Kurt Ruetzler, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: All author contributed to the design, writing and review of this paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of authors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kurt Ruetzler, FAHA, MD, PhD, Academic Research, Assistant Professor, Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, United States. ruetzlk@ccf.org
Received: February 2, 2021
Peer-review started: February 2, 2021
First decision: March 30, 2021
Revised: April 13, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: August 15, 2021
Processing time: 187 Days and 18.5 Hours
Core Tip

Core Tip: Diabetes is a common endocrine condition with multiple organ system involvement. Careful preoperative assessment and perioperative management is crucial in preventing perioperative morbidity and mortality in patients with diabetes presenting for surgery. The focus of preoperative risk assessment should be to assess and optimize the level of glycemic control, as well as identification of possible systemic comorbidities. Intraoperatively the focus is to ensure euglycemia, prevent metabolic and electrolyte derangements and maintain adequate organ perfusion. Postoperatively patients should be transitioned back to their home regimen once adequate oral intake is established.